Hemolytic Anemias Introduction

Normal red cells have a life span of about 120 days

All hemolytic anemias are characterized by

(1) an increased rate of red cell destruction

(2) a compensatory increase in erythropoietin levels and erythropoiesis that results in reticulocytosis

(3) associated with a marked erythroid hyperplasia within the marrow and an increased reticulocyte count in peripheral blood.

Normal M:E ratio in marrow is 3:1. This ratio decreases in hemolytic anemias.

(4) the retention by the body of the products of red cell destruction (including iron, bilirubin, Hb )

Intravascular hemolysis

leads to :

Hemoglobinemia, hemoglobinuria
Hemosiderinuria
unconjugated hyperbilirubinemia and jaundice.
Haptoglobin levels are depleted

Extravascular hemolysis

takes place within the macrophages of the spleen and liver. Any reduction in red cell deformability leads to splenic sequestration, followed by phagocytosis.

not associated with hemoglobinemia and hemoglobinuria
often produces jaundice
can lead to the formation of gallstones ( pigment stones).
Haptoglobin levels are decreased
splenomegaly.

Some of the hemolytic anemias are:

Hereditary Spherocytosis

Sickle Cell Anemia

G-6-PD Deficiency

Thalassemias

Immunohemolytic anemias

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